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Affidavit of Domicile

Finn: Sol

1, __________________ (State Your Role), residing at  ________________________, being first duly sworn, state as follows:


I am the _____________________ (Your Role) of the Estate of ___________________ (“Decedent”) who died on ____________ (“Date of Death”).


At the time of death, the Decedent's domicile was  _____________________________, and the Decedent had resided in the State of ___________________ and was not a resident of any other state of the United States at the time of death.


The Decedent did not claim any state of domicile other than the State of _____________

on any instrument or Will executed within the two years prior to death.


Certificate(s) representing ___________________ were physically located in ________, at the time of the Decedent's death.



Maker of Affidavit


Subscribed and sworn to before me this __ day of ________, 20__.                      




Notary Public

My Commission Expires on: ______________